Betsy Jo Bolton, PA-C
Individual provider Active NPI Surgical Physician Assistant · Clive, IA
NPI 1144574997 · NPPES record last updated Jun 13, 2024
Key facts
- NPI
- 1144574997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 002351 (IA)
- Practice address
- 12499 University Ave Ste 210
Clive, IA 50325-8288 - Phone
- (515) 440-2676
- Fax
- (515) 440-2677
- NPI assigned
- Nov 1, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Knoxville Community Hospital Inc
Capital Orthopaedics and Sports Medicine PC
Broadlawns Medical Center
Practice addresses (Care Compare)
1002 S Lincoln St
Knoxville, IA 50138-3155
1202 W Howard St
Knoxville, IA 50138-3103
Phone (641) 828-7211
12499 University Ave
Suite 210
Clive, IA 50325-8288
Phone (515) 440-2676
1801 Hickman Rd
Des Moines, IA 50314-1548
Phone (515) 282-2200
1801 Hickman Rd
Des Moines, IA 50314-1597
2222 Philadelphia St
Ames, IA 50010-8700
Phone (515) 440-2676
Hospital & facility affiliations
- Knoxville Hospital & Clinics
- Mercyone Des Moines Medical Center
- Broadlawns Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130128000426 | IA | Practitioner - Physician Assistant | 2567616550 | Reassigns benefits to 8 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002351 | IA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Knoxville Community Hospital Inc | Current |
Accepting new patients | |
| Broadlawns Medical Center | Current |
Accepting new patients | |
| Central States Medicine, PLLC | Medical | Current |
Accepting new patients |
| Boone County Comprehensive Specialty Care | Current |
Accepting new patients | |
| Boone County Hospital | Current |
Accepting new patients | |
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Boone County Hospital | Current |
Accepting new patients | |
| Capital Orthopaedics and Sports Medicine LLP | Past | Accepting new patients |
Locations
1015 Union St
Boone, IA 50036
Phone (515) 432-3140
1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200
1002 S Lincoln St
Knoxville, IA 50138
Phone (641) 842-1464
6001 Westown Pkwy
West Des Moines, IA 50266
Phone (515) 224-1414
2425 Westown Pkwy
Ste 100
West Des Moines, IA 50266
Phone (515) 222-8346
Interoperability endpoints
- https://api.platform.athenahealth.com/19659/brand/1/csg/1/fhir/r4
- bbolton3928233@direct.trinity-health.org
- bbolton267330@uihcdirect.org
- bbolton132571@direct.unitypoint.org
- betsy.bolton.1@19659.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 002351 | IA | |
| Physician Assistant | 363A00000X | |||
| Surgical Physician Assistant | 363AS0400X | 002351 | IA | Yes |
Addresses
Primary practice location
12499 University Ave Ste 210
Clive, IA 50325-8288
Mailing address
2425 Westown Pkwy Ste 100
West Des Moines, IA 50266-1425
Phone (515) 267-1819
Other providers in Clive, IA
- Naomi E Bloom
- Jill Yvonne Bloss
- BMF Transportation LLC
- Kaylee Boelter
- Devon Nicole Boes
- Diana Bonus
- Abbey Elizabeth Bos
- Megan Bosak Duff
- Kaitlyn Bottorff
- Haleigh E Bouslog
All providers in Clive, IA · Surgical Physician Assistant in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.